Still Old and Tired
A Personal Lesson in Elder Adaptability

Pinnacle of Adaptation

category_bug_geriatrician.gif [EDITORIAL NOTE: I am proud today to launch a new category at Time Goes By, The TGB Geriatrician. It's been a long time in planning and I'm proud that Dr. Bill Thomas has agreed to take on the duties of writing this column which will appear in the first and third weeks of each month.

Dr. Thomas is a world-renowned geriatrician and advocate for the dignity of elders. Long-time readers of TGB will be familiar with him from the many times I've quoted from his book What Are Old People For? You can find out more about Dr. Thomas here, and he also keeps his own daily blog, Changing Aging. I know you will welcome him to the TGB fold.]

I am excited about guest blogging here with Ronni Bennett. TGB is a terrific blog and if I can add something of value to this community, I will be happy.

I am a physician and my background is in Family Medicine and Geriatrics.

My approach to medical issues tends to focus more on the big questions of emphasis and interpretation and less on specific remedies. (Although I do get into that from time to time.) In medical school we used to joke that certain professors seemed to have favorite molecules that they studied exhaustively. That's never really been my thing.

What do I mean by big ideas? Well, how about this: I believe that older people are the healthiest people on the planet.


Aren't old people sick most of the time? What about all of the billions of dollars we spend on Medicare? What about the statistics that show older people using the most health care resources per capita of any age group?

Those objections are valid, but they miss the deeper reality. In order to become an older person one must first have a healthy childhood, then it is on to decades of healthy adulthood. When the second half of life arrives, a person can already boast of a long span of very good health. The people who are really unhealthy, sadly, do not make it to old age.

Furthermore, statistics show that almost half of all Medicare expenditures are made in the last six months of life. Before the last six months, older people do pretty darn well.

It is true that the second half of life includes experiences related to loss, but it is also true that elderhood is not limited to these things. As we age, we encounter an unexpected and highly significant rise in the power of adaptation. The emergence of adaptability is perhaps the most important and least acknowledged of the virtues of aging.

The young grow accustomed to running faster and jumping higher with each passing year and the middle decades are marked by a struggle against the workings of gravity and time. Fortunately, elderhood provides us with new and supremely useful perspectives on flexibility and the reality of change over time.

An older person wakes up to a new body with new requirements and limitations not once, but many times. This reality batters our relationship to the status quo. Mental, physical and spiritual changes require elders to develop and deploy a string of enterprising strategies and subtle adaptations.

While it is true that muscles weaken in late life, it is also true that older people are less likely to report symptoms of depression than younger people. Hair may turn white, get thin and fall out but, when surveyed, older people often report an enhanced sense of wellbeing. We grow shorter rather than taller, our toenails turn yellow and our arches fall and still, many older people report that their health is good or even very good.

These seeming paradoxes are actually the fruits of adaptation which grow in tandem with and are nourished by the decline in physiological function.

A young man, transported magically into the body of his 80-year-old self would struggle to complete even the most basic tasks. Sitting, standing, dressing and walking would be difficult for him because the thoughtless ease of youth had left him ill-prepared for life in elderhood.

We need old age because it allows the body to instruct the mind in patience and forbearance while the mind tutors the body in creativity and flexibility.

Our culture discounts the fruits of aging. For example, we value (without even realizing that we are doing so) the long springy stride and narrow tandem gait of youth. The young trumpet their virtuosity, wearing preposterous shoes and paying no mind to the terrain underfoot. Actors and politicians have long understood how we unconsciously judge others by their stride. They lengthen and narrow their stride when they are in public and, in doing so, give the appearance of youth.

Trackers can easily determine a person's age by examining their footprints. Compared with the fluid stride of youth, the marks made by an older person can seem tentative and ungainly. This appearance is deceiving. The reality is that when elders walk, they execute a highly evolved, richly detailed strategy that maintains upright ambulation even into the last decades of life.

Old people alter their gait in specific ways that account for very real changes in strength, endurance, coordination, sensation and reaction time. The "shuffling gait" keeps the feet close to the ground and maximizes input from position sensors. The stance is widened to improve balance. The number of steps taken per minute is decreased to accommodate changes in endurance and to allow for increased reaction time.

Keeping a human body upright and moving is a spectacular feat of coordination and reaction under any circumstances. Doing so in the ninth decade of life magnifies rather than diminishes the beauty of this achievement.

When the world's best golfers come together to play a tournament, the course is lengthened and the rough deepened so that their skill might be tested fully. Olympic divers challenge themselves with the most difficult dives, not the easiest. The Tour-de-France includes the most taxing climbs on its route, including some that are rated as "beyond category" in difficulty.

When you see an old woman walking, you are witnessing a similarly exciting, high-level performance. This is a tightly choreographed ballet, the product of decades of refinement. Watch and marvel. Miracles are all around you, once you know where to look.

[NOTE: You are welcome to suggest topics for future columns of The TGB Geriatrician by leaving a note in the Comments section below or sending an email via the Contact link in the upper left corner of this page.]

[At The Elder Storytelling Place today, an announcement.]


Welcome to you Dr. Thomas.
After reading your column this early morning - I am smiling and feel pretty good about my rolling past 3 score and 10.
I just finished reading your book "What are Old People For"
Thank you for your uplifting information.
Looking forward to your future columns.


Thank you, and welcome. I am already looking forward to next month's column. And a big thank-you to Ronni for bringing you to her readers.

I have a question you might care to consider one of these days: do you think that television, being such a one-dimensional, one-way medium (as opposed to the Internet, which is much more interactive), has a similarly detrimental effect on old people's brains to what it does on the brains of very young children who need to interact in order to increase the connectivity of neurons?

My gut tells me that the more interactivity we continue to have with the world, the better it must be for our synapses. But TV, whilst it holds the attention by giving the illusion of involvement, requires little or no response.

I guess I'm biased because I dislike TV and haven't had it in the house for 23 years. But when I visit my two nonogenarian cousins and find them perpetually staring vacantly at the TV screen I can't help but wonder if this is helping to hasten the deterioration of their thinking function.

Obviously TV plays a useful role by keeping them in touch with the goings-on in the wider world. But is it not damaging to them to be staring at it the entire day? (And if so, shouldn't we be reminding each other about that danger, for future reference?)

Ah! A glimpse of the forest for a change. It is indeed refreshing for someone to offer some perspective on the aging process that isn't marketing, political or ageist.
I heartily agree with the Doctor's comments and would only add a suggestion that we all start the day with a thought of gratitude for the unique opportunity to experience the
progression of time and the ability to actively partcipate in the moment (albeit with "shuffling steps")

Thanks for the upbeat and positive first column Dr. Thomas. It's good to have you here.

I am so happy to have you here, Dr. Thomas. TIME GOES BY is my morning 'fix' and I look forward to reading your columns here.

I have your book on my nightstand and read (and re-read)a chapter each night.

It is comforting to know that my halting steps are nature's way of keeping me upright. Your positive spin on adaptability is nice to hear.

Thinking about the ways we adapt to the changes in our bodies makes me aware of how many different ways I have adapted to other changes in my life. For example, I used to hate being alone and I now cherish it.

Welcome Dr. Thomas. I was gripped by your description of how we move. I am a younger older person myself (only 60) but also a runner. And I ponder all these adaptations in myself in emerging form -- the shorter stride, the wider stance, a certain enhanced caution. None of this shows much, I don't think, to an exterior observer (they just think I'm too slow to be pretending to do this, I fear.) But I'm pretty attuned to myself and can feel the changes. My body is what it is -- I like that it can keep going.

What a delightfully charming, realistic, and yet hopeful way you have in expressing things!

Thank you!!

Thanks for your advice and observations, Dr. Thomas. You are most welcome...And we all look forward to more of your columns.

If they are all as interesting and informative as this one was, we have a treat in store.....

Thanks for your insightful perspective. You got it. At seventy-two I am more engaged with the world and with my own mental and physical health than ever before. I am living an incredibly exciting period of human history, learning and integrating in such a way that must only come with age. Crisis and opportunity are meeting head on and those of us who’ve seen more than a few decades of radical, accelerating change can greatly benefit our society by simply being the good models of integrated aging that younger people can look forward to becoming.

I believe it is as stated by Joan Halifax: “The wisdom that we need to solve our problems lies encoded in the depths of our unconscious minds, but it must be evoked by elders who reveal our potentials.”

Welcome!!! And what a great positive column to begin! I think we elders learned a lot about survival growing up. I'm wondering if the generations that follow us will do as well.

A woman at the care center where my dog Darwin and I do pet therapy is turning 106 today. She is mentally alert, remembers her entire catechism in Swedish from 1912, happy and still walking with just the aid of a walker.

May we all be so healthy!

What a wonderful column to start the series! I was surprised to read about the high cost of the last months of life. How much better it would be all around if there were more seniors in hospice care at that time of life. I've seen it in practice and know that's how I would want to go.

I also feel amazed to see how well I feel at 64, given my parents' and their parents' conditions at the same age. Could it be related to better dental care? I'm the first one in my family to have all my teeth at this age. Perhaps I eat better and that translates into better all around mental and physical health.

Looking forward to more insights from your experiences.

Welcome! I shall certainly pay more attention to my own and other's gaits now that I know what to look for!

Dr. Thomas' regular contributions are a welcome addition to TGB. The thoughts he brings to understanding aging, descriptions of the actual real life experience of aging, is a refreshing perspective compared to so much of that to which we are subjected in regular press and ads.

More and more I find TGB is where I can find accurate pertinent information about aging all in one place, unlike other Internet web sites.

Hello and welcome Dr. Thomas...I loved your first column, and we are indeed lucky to have your intriguing ideas and thoughts to contemplate...very interesting about the adaptability issue...change is good, and good for you. I think I knew that, but it is nice to be reminded...

I have a rancher friend who does really hard labor by virtue of the need of the cattle. He is also getting up there in years. He says-- I work smarter not harder.

Dr. Thomas it is great to find out how highly adaptable elders are in a lot of endeavours. However; I find it somewhat puzzling when it comes to pursuing entrepreneurial activities that adaptability seems to have a different meaning. Can you tell me why most elders (60 Plus) still want too much secuity and entitlements; instead of trying to make the last stage of their life more creative, productive, exciting and even somewhat adventerous?

Thank you, Dr. Thomas for your provocative insights. I welcome your appearance on Ronni's blog. But I question your comment that it's "true that older people are less likely to report symptoms of depression than younger people." Perhaps you mean that while depression may actually be more commonplace among older persons than among younger folk, the elders are less willing to accept and admit that they suffer depression and are thus less willing to seek assistance. I hope you will discuss the subject of depression and the elderly in future columns.

When I was in art school the professors would tell us that we "look but do not see". I would respectfully add the words "how to look" to "where to look".
I'm so glad for your participation here. Your book is brilliant. Thank you.

Dear Dr. Thomas - Welcome!!! There is a prayer in Hebrew that one (who is religious) says upon awaking in the morning - thanking God for restoring my soul etc. Reading your article, I feel that you have started the restoration of my soul. For I have lived six 1/2 decades and am going through a mental struggle with "adaptation" ala mood swings and acception of the what is...I'll keep on reading - if you keep on writing. Thank you so much!!!

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